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Monday, July 26, 2010

Medical Mondays: A Tale of Two C's

Happy Monday! Erica from Chapter by Chapter had a great question of what the difference was between being catatonic and being in a coma.

The words "catatonic" is thrown around in conversation all the time. But what does it really mean?

A person with catatonia can exhibit several different symptoms, such as:-bizarre posturing-waxy flexibility (staying in awkward positions when placed in them by other people)-purposeless resistance to commands or being moved-repetitive, meaningless actions or spoken phrases-echolalia, or repeating phrases spoken to them-echopraxia, or copying other people's gestures

Catatonic persons may maintain rigid postures for hours, and ignore external stimuli. There is another form, called catatonic excitement, in which the person exhibits constant, hyperactive activity.

Catatonic schizophrenia is a subtype of schizophrenia, but catatonia can also be seen in other psychiatric disorders such as bipolar disorder, post-traumatic stress disorder, and depression.

Medically, it can be seen in encephalitis (inflammation of the brain), drug overdose, autoimmune disorders, and neuroleptic malignant syndrome.

So. What's the difference between catatonia and a coma?

A comais a state where the person is deeply unconscious and cannot be awoken. There's one huge difference. Catatonic patients are awake when exhibiting these symptoms.

Also, the causes of coma are exclusively medical, rather than psychiatric, such as head trauma, overdose, stroke, a low oxygen insult, amongst others.

Please keep in mind this post is for writing purposes only and is not to be construed as medical advice!

I agree with the above commenter... before coffee, I'm rather catatonic as well ;)

I had no idea there's a difference. My goodness, how do you come up with these questions? I love coming over here and learning all these medical-related things! Saves me from pestering my sister-in-law constantly with medical-related questions... haha.

Hi! Great post! I have a question :o) Is it possible to be shot in the head, survive, lose all long term memory, but still function like normal, and retain all short term memory from rehabilitation onward?

Yay! I got my own Medical Monday! Thank you so much for the very helpful information. I'm not sure which of these my character will go into though, not because of the information you gave me, loud and clear there. I'm just not sure which would work best for the story line. Sigh.But now at least I know the difference! Thank you so so much. I will be "plugged in" soon and back on the blogs as usual.One last thing if you're able to answer. How is a catatonic state treated...how long can it last, and how do they get fed or go to the bathroom. This would be the not so hyper kind I'm askin about. If you're able to clarify that I will love you forever ever! Thanks Lydia your the best!

Hey Erica!Your follow up question got more detailed than I could handle, so I did what any internist would do in a situation like this...I called a consult!I asked Laura Diamond (of Mental Health Mondays fame) and here is her response (summarized).

The duration is variable...depending on the severity, people may be incontinent or actually can toilet if brought to the bathroom...the catatonia can vary by day or hour too. Some will talk fine in the morning, but may be completely mute by afternoon. They can be very still or very agitated & engage in regressed behaviors like smearing feces, etc. Eating is possible--they might eat constantly, but may not speak and have agitated behaviors like smearing feces and urinating on the floor constantly. Of course, fluid & eletrolyte status is monitored--IVs may be necessary...

Treatment includes antipsychotics--injection, by mouth, or dissolveable...ECT(electroconvulsive therapy aka shock treatment) is a treatment too.

Okay so my internet was down and I couldn't wait to see if you had gotten back to my additional question. AH! I feel bad that you had to do a little more research than usual :( but I'm so glad you did cause it seals the deal on which state I am puttin my characters in. I don't think I can write a fecal smearing scene at all. Thank you SOOOO much! You're the best! (((((hugs))))

Lydia, I'm wondering if you'd be comfortable answering some more questions about comas for me? I've a character in my current WIP who's sustained a head injury, and there are some (general) things I need to understand about a comatose condition. Would you mind if I compiled a list of questions for you?

If you've the time, please e-mail me at jannawritesATyahooDOTcom. I tried to access your e-mail address from your Blogger profile, but Outlook gave me fits. :(

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